On 24 November 2024, Youth and Sports Ministerial Decision No. 1642 approved healthcare and medical procedures for youth and sports bodies and facilities. It required a unified medical screening code and emergency equipment to protect athletes and reduce sudden-death risks.
Implementation, effective from 3 January 2025, brought conflicting club and federation instructions over where and how athletes of different ages and categories should obtain clearance, adding financial and administrative burdens for families.
Initially, some clubs insisted on military or police hospitals for the required official stamp. Tests cost EGP 2,000 or more in some places, says Samah Sayed, mother of a swimmer at a Cairo club, prompting weeks of searching for cheaper alternatives.
She eventually used the Islamic Cardiology Centre at Al-Azhar University’s Faculty of Medicine for Boys. Her son received an ECG, echocardiogram, respiratory-function test and complete blood count for his swimming-federation registration at a cost of EGP 800.
Samah criticises applying the same requirements to children still learning, including those aged five to seven. The expense is particularly heavy for families with several children, she says, and has led some to stop swimming or other sports.
“The medical code often becomes a formality: the papers are not properly reviewed or used,” she tells Zawia3. She points to continuing fainting, breathing emergencies and health crises during training and competition, believing the process sometimes serves mainly to limit club or federation liability.
She says the swimming federation later revised charges by category after parents objected, but clubs applied the changes unevenly. Some arranged on-site medical convoys; other parents sought cheaper hospitals, with some performing all tests thoroughly and others allegedly issuing paperwork without completing examinations.
Rabab Hassan, mother of a karate athlete in Alexandria, used Abu Qir General Hospital last year for EGP 280. She describes poor cleanliness and requests by some staff for money to move people ahead in the queue.
After the difficulty reaching the examination room, she found the assessment superficial. “The alternative was military or police hospitals at roughly EGP 1,400, a financial burden for most parents,” she tells Zawia3.
For the 2026/27 sports season, she says, the ministry offered examinations at Abu Qir Youth City for EGP 500 and appointed an Alexandria coordinator to gather athletes through clubs, youth centres and academies for doctors’ visits, a service previously unavailable.
At the start of 2026, the Central Sports Medicine Administration designated Thursdays for screening at the Maadi Olympic Centre’s sports-medicine unit. Applicants were asked to bring a recent photograph and a birth-certificate copy and pay by card.
Heba Mohamed, a women’s boxing coach in Assiut, says she must take more than twenty athletes to Cairo for testing costing around EGP 1,500 each, on top of travel.
The team then returns to Assiut before raising further money for travel, accommodation, food and entry fees for a Cairo championship. Those cumulative expenses exceed many families’ means, she says.
Assiut has a sports-medicine unit, but it provides only internal-medicine assessment and ECG rather than all required tests, Mohamed says. Fully equipping governorate units would reduce journeys to the capital and help provincial athletes remain in competition.
Financial and administrative burdens
After complaints throughout 2025, then minister Ashraf Sobhy announced reduced screening costs on 17 January 2026 within ministry sports-medicine units and medical convoys. He left office weeks later in a cabinet reshuffle and was succeeded by Gohar Nabil, as the Arabic report recounts.
Decision No. 109 of 18 January 2026 amended medical and health requirements. Its first article obliged youth and sports bodies, sports-service and investment companies, factory-company and ministry clubs and specialist federations to protect athletes, reduce sudden-death risks and establish preventive measures, comprehensive periodic assessment and emergency plans. Article 2 specified four screening levels according to participation.
Level one covers general participation outside high-performance competition, with no advance tests required but general safety measures and equipped medical facilities, including resuscitation and first-aid equipment.
Level two, for academies and training centres, costs EGP 200–250 and covers the athlete’s and family’s medical history, clinical and internal-medicine examination, ECG and complete blood count.
Level three, for national championships and federations, costs EGP 400–500 and adds an echocardiogram to level-two examinations. Level four, for national teams, adds an exercise ECG to level three. Tests and examinations remain valid for a year and can cover an athlete participating in more than one sport under approved rules.
Months after the amendment, professionals, amateurs and parents still report clubs requiring particular hospitals, companies or medical convoys at higher prices without observing those four-level charges.
Mohamed Mansour, father of three children taking swimming and karate at a Cairo private-sector company club, says tests sometimes cost around EGP 2,000 and parents are directed to police or military hospitals despite cheaper public alternatives.
In June, he found joining a sport required multiple tests, a computer-issued birth certificate and a parental responsibility declaration. He criticises substantial paperwork alongside allegedly incomplete examinations that undermine the code’s purpose.
He questions repeated tests when players change clubs, resubmission of existing documents and restrictions to particular providers, arguing that procedures complicate participation without addressing neglect or poor safety.
Ahmed Ayoub, a children’s football coach at a private Cairo academy, says approved providers’ charges range from roughly EGP 850 to EGP 1,500, imposing unequal burdens without clear common standards.
Some hospitals tell parents children must fast for particular tests while others do not, he says. Having taken his own son for screening, he found neither consistent nor comprehensive application, with different prices and procedures.
Ayoub wants better pitch-side care and approved medical convoys operating within clubs so athletes can be assessed where they train. High fees can cause families to withdraw children, undermining talent development, he warns.
He proposes a joint youth-and-sports and health ministry initiative offering nominal-fee or free screening, drawing on sports-medicine units, company clubs, business contributions and private hospitals’ free-care departments, with common rules to support equal opportunity.
Additional burdens for Paralympic athletes
The ministry announced eighteen sports-medicine units in January 2026. Cairo’s is at the Maadi Olympic Centre; Kafr al-Sheikh’s in a standalone stadium building; Dakahlia’s beneath Mansoura Stadium stands; Menoufia’s in a separate building at Shebin Stadium; Sharqia’s beneath Zagazig Stadium’s pool; Ismailia’s at the international pool in Sheikh Zayed; North Sinai’s at Al-Arish Stadium in al-Dahiya; and Qalyubia’s beneath the youth-and-sports directorate.
Other listed units are at the directorate pool on Aswan’s Nile corniche; Fayoum Stadium; Abu Qir Youth City in Alexandria; beside Beheira’s directorate; Port Said Sports City; al-Arbaeen Stadium in Assiut; Qena’s indoor hall; opposite Youth City in al-Kharga, New Valley; beside Suez’s directorate; and Beni Suef Stadium. This is the eighteen-unit list published in the source report, rather than a guarantee that every location offers every test.
Paralympic athletes face particular difficulty. Abdel Rahman Mohamed, an Alexandria swimmer with a physical disability, says requirements to use specified locations—often Cairo’s Olympic Centre—add costs and hardship for athletes and families travelling from governorates. He wants local services through directorates, insurance or approved convoys.
Travel and accommodation add to examination fees, recurring each season and sometimes for several family members. Mohamed believes accident prevention should prioritise sound competition organisation, equipped ambulances and complete medical teams, rather than additional charges that do not themselves address emergency-response failures.
He warns that expense may end talented athletes’ careers and proposes designated local screening days that protect participation and equal opportunity.
Paralympic table-tennis player Sameh Eid says athletes with physical disabilities find travel to Maadi particularly difficult. He describes ministry units as available in only sixteen governorates; that claim is distinct from the report’s list of eighteen units.
Eid says Paralympic athletes receive no remuneration before winning a Games medal and cover training, travel and competitions themselves. Team travel and accommodation can cost EGP 30,000–40,000 against a Paralympic club budget that may be only EGP 100,000. These are his account of the funding pressures.
Medical screening and hospitals’ different prices
Ahmed Ashraf Issa, consultant in cardiology, interventional procedures and sports cardiology at Ain Shams University’s cardiac-surgery academy and president of the Egyptian African association for heart research and disease, describes the code as a unified pre-competition assessment and documented medical database, focused particularly on heart health, early detection and risk reduction.
He says basic assessments include history, clinical examination, ECG, echocardiography and laboratory tests, with exercise ECG, cardiopulmonary assessment, chest imaging and other tests added according to sport and continental or international federation requirements. These clinical descriptions should be read alongside the distinct participation levels, including general participation without advance testing.
“The code responds to international screening standards and health incidents witnessed in Egyptian sports,” he says. “Sports cardiology assessment is no longer optional; it is central to developing the system and protecting athletes.”
Issa says screening cannot prevent every death but can improve discovery of dangerous conditions before competition, allowing treatment or participation restrictions following medical review. It cannot predict every new circumstance, including severe exertion, stress or emerging illness.
He describes electrical and congenital heart disorders as important in sudden deaths below age 35 and coronary disease as more prominent at older ages. Some electrical pathways can be treated before return to competition, he says. He cites obstructive hypertrophic cardiomyopathy as a condition that may prompt exclusion and family genetic assessment, with a specialist committee reviewing the case and informing the club and federation. These are the interviewee’s clinical views; participation decisions require individual specialist assessment.
It is too early for reliable national cardiac-disease rates among athletes, Issa says: the code is recent and assessment needs several years of data. He has personally examined more than 5,000 professionals, most without conditions requiring exclusion, with a limited proportion needing treatment or restrictions.
On fees, he says the ministry issued indicative prices within approved bodies and companies but cannot require every private hospital to charge one rate. Providers outside the binding arrangements may charge more according to operating costs.
He rejects claims that fitness certificates can be obtained without examinations as “unfounded” and says parents’ complaints over cost, implementation and approved providers fall within the ministry’s Supreme Medical Committee’s remit.
Club arrangements and ministry rules
Hazem Khamis, chair of that committee, says it sets screening requirements and prices in ministry centres and contracted companies. A club’s arrangement directing parents to a particular convoy or provider is its own arrangement, rather than a ministry rule.
Ministry centres must apply approved rules and prices, he says. He cites EGP 500–750 in ministry-contracted bodies depending on category, whereas hospitals and other providers outside ministry supervision set their own charges. That range differs from the EGP 200–250 and EGP 400–500 level prices cited earlier in the report; the testimony does not explain all reasons for the difference.
“Clubs cannot, under the regulations, require a particular hospital or convoy if the athlete supplies a complete certificate from an approved government body carrying the required official stamps,” Khamis tells Zawia3. “Rejecting such a certificate may expose the club to accountability.”
Eligible government providers include public, university, military, police and public-authority hospitals offering the service, alongside ministry-accredited private companies. Some clubs contract directly with companies for on-site convoys at higher prices, he says, separate from ministry regulations.
On insurance-funded screening, Khamis says children up to eighteen have state-funded health insurance, but adding the code’s tests to universal health insurance requires assessing system capacity while that newer system expands gradually across governorates.
He says the committee continues developing the system to safeguard athletes and unify pre-participation standards, while some complaints arise from club implementation or providers outside direct ministry supervision.
The medical code’s success depends on consistent, fair implementation balancing safety with affordability. Officials say their regulations do not require a particular provider, yet athletes and parents describe inconsistent enforcement and costs that can exclude participation. Better-equipped local units, club oversight and accessible screening remain central demands.
